Friday, April 06, 2007

Canadian Injured Workers Society - Workers compensation. Medical profession, Independent Medical Examinations (IME s). WCB doctors.

The Journal of Disability Medicine | American Board of Independent Medical Examiners

Workers Compensation Board: History of WCB

ΛUSTIN ΛTHEIST ΛNØNYMØUS: Woody and Billy on Sunday Morning

ΛUSTIN ΛTHEIST ΛNØNYMØUS: Woody and Billy on Sunday Morning

There will always be a soft spot for Billy Graham in my heart. He is the only one of the evangelists that has not compromised his message by his rudeness and incivility (and "immorality" and double standards). Here is a wonderful video of two men with obviously differing views, who manage to be civil and courteous. Somehow I cannot imagine Jon Stewart eliciting the same response from "Dr. Dobson" in today's polarized and "other" centred religious climate.

Wednesday, April 04, 2007

Fewer Doctor Visits Approved for Rural, Isolated Towns :: News ::

Public Health Agency Linked to Chemical Industry | Mostly Water

Telling the Truth about Tar Sands Cancer Rates? Get Ready to Defend your Job... | Mostly Water

Famed environmentalist outraged by criticism of whistleblowing Alta. doctor

Famed environmentalist outraged by criticism of whistleblowing Alta. doctor

More on the Cancer Whistleblower situation:

Famed environmentalist outraged by criticism of whistleblowing Alta. doctor

Tim Naumetz
For CanWest News Service

Thursday, March 08, 2007

OTTAWA - The lawyer famous for his battle against a tannery that contaminated drinking water in a Massachusetts town says it is "outrageous" Health Canada complained about an Alberta doctor who suggested chemical contamination might be behind cancer deaths downstream from oilsands refineries.

Boston lawyer Jan Schlichtmann, played by John Travolta in A Civil Action, the Hollywood movie based on Schlichtmann's legal fight in the 1980s, says he was astonished at reports Health Canada filed a complaint against the Fort McMurray physician, Dr. John O'Connor.

"I think it's outrageous that they would try and shut up somebody who's trying to sound the alarm bell if there might be something going on," Schlichtmann said in an interview from his Massachusetts law office.

"The history is that environmental contamination can cause a population severe health effects, including cancer, and that the professionals who serve them have to be vigilant," added Schlichtmann, who won a long legal battle for leukemia victims in Woburn, Mass.

An Alberta government official confirmed Health Canada filed a complaint with the Alberta College of Physicians and Surgeons after O'Connor challenged the conclusions of a government analysis of cancer and other deaths in the mostly Cree population of Fort Chippewyan last year.

Details of the complaint are confidential, and Health Canada would not directly confirm the complaint, but the official said he understands it was submitted by Health Canada physicians.

"This is a professional practice issue and is a matter for the Alberta College of Physicians and Surgeons to address," Health Canada said in an e-mail response to questions.

O'Connor, who treated Fort Chippewyan residents by flying in from his Fort McMurray practice, said in May 2006 he was alarmed by what he considered high rates of cancer in the community. He speculated cancer-causing chemicals might have entered the Athabasca River from massive oilsands refineries upriver from the town.

A study of vital statistics by the Alberta Health and Wellness Department and the Alberta Cancer Board, with the support of Health Canada, concluded the overall cancer mortality rate for Fort Chippewyan was slightly lower than the rate for the rest of Alberta.

But more detailed figures released by the Alberta government this week show higher than expected cases of colorectal cancer, liver and bile duct cancers, leukemia and lung cancer.

The 2006 report noted rates of diabetes, hypertension and death by injury and poisoning were above provincial averages and said a focus on those areas would improve the "overall" health of the community.

Schlichtmann said public officials must be open to public scrutiny and O'Connor appeared to be acting "in the finest tradition of what a doctor should be doing."

"A community that polices itself and silences its members is a community that has a cloud over its future," he said. "If they have any doubts about that, let them go look to the communities in Woburn, Massachusetts. People suffered in ignorance."

Members of the Fort Chippewyan community are calling for a wider first-hand study, including statistics for all cancer patients, not just those who died of cancer.

The head nurse with the Nunee Health Authority in Fort Chippewyan says four of about 11 deaths she has recorded in the hamlet since last May have been caused by cancer.

"It seems we have a lot; as a nurse I have to say that," said Georg MacDonald. "We don't have a study, we don't have a study of the living patients in Fort Chippewyan. To my mind, just off the top, I would say there is an awful lot of liver cancer."

O'Connor has been unavailable to comment this week.

Ottawa Citizen

NRM: Health Canada muzzles oilsands whistleblower

NRM: Health Canada muzzles oilsands whistleblower

If I remember correctly, last year on CBC the Alberta Health and Wellness people were saying that this would be a peer reviewed process. So far they have not lived up to these expectations.

This is frightening beyond belief. The oilsands COULD be poisoning people , but government and industry and the medical establishment are essentially shooting the messenger- John O'Connor, a physician, who noted a fairly substantial rate of odd cancers in the mostly native population of Fort Chip. Now the doctor is a nervous wreck because he spoke out about this.

Does he deserve this? No. Unfortunately, it is easier to dispense with a doctor than it is to clean up the environment.

It is a national disgrace.

Full Article Here:

MARCH 30, 2007 VOLUME 4 NO. 6


Health Canada muzzles oilsands whistleblower

AB physician sounded cancer alarm, slapped with College complaint

By Peter Woodford

Elevated cancer rates in Fort Chipewyan support Dr O'Connor's claim
From Fort Chipewyan Health Data Analysis by Alberta Health & Wellness and Alberta Cancer Board, April 2006
A northern Alberta physician who publicly aired concerns over carcinogenic pollution from the massive oilsands development is being investigated by the province's College of Physicians and Surgeons. The complaint against him comes from none other than Health Canada, which claims the physician caused "undue alarm."

The doc — widely held to be Dr John O'Connor of Fort Chipewyan — says he's got a hunch the copious amounts of arsenic dumped into the water by the project might explain why so many of his mostly aboriginal patients are presenting with cancer — including rarer forms like cholangiocarcinoma (bile duct cancer).

The College won't confirm or deny that Dr O'Connor has indeed been targeted. The family doc is no firebrand and an unlikely martyr for the environmental cause. When the government released selected data from a study and concluded that people in the community were less likely than the average Albertan to die of cancer, it pained him to disagree (fuller data, released later, would suggest his hunches were largely right). "I would absolutely accept it, if I saw they had done a complete analysis..., had all the information that they needed, and had the report peer reviewed prior to publishing it," he said at the time.

In fact, the whole business of fighting with the government made him literally sick and he said that he's planning to leave Fort Chip (as it's known locally) in the summer because of it. "It's been so consuming and so frustrating that my blood pressure has gone up and I have difficulty sleeping," he told the CBC late last year — even before the complaint to the College was filed. "It's just I'm worn out by this."

Dr O'Connor is now refusing to speak to the media until the complaint with the College is settled, his lawyer says.

Colleagues and members of the community came to the quick conclusion that Dr O'Connor is paying the price for attacking a sacred cow — Alberta's multi-billion dollar oil industry.

"It's a similar scenario to what had me fired in 2002 for speaking in favour of ratifying the Kyoto Accord in the interest of public health," said Dr David Swann, Liberal MLA for Calgary Mountain View, on his blog. Dr Swann was medical officer for the Palliser Health Region at the time he got the axe.

"I admire Dr O'Connor for his courage in standing up and speaking out on issues that should concern all Albertans," added Dr Swann in a March 6 interview with Fort McMurray Today. "This is not acceptable. We're a free country. We, as professionals, are called upon to act in the public interest and to raise issues, to challenge vested interest whether it's government's or industry's monetary interest for the betterment of the society."

Dr Swann and internist Dr Michel Sauvé — who's head of the intensive care unit in the same Fort McMurray hospital where Dr O'Connor is based and also regularly flies in to Fort Chip to treat patients — both feel that this case is evidence that whistleblower legislation is needed to protect doctors. Dr Sauvé has said he thinks the complaint was "politically motivated."

The parties involved in the alleged complaint against Dr O'Connor aren't saying much.

"We can confirm that Health Canada physicians have lodged a complaint which involves several professional practice issues with the Alberta College of Physicians and Surgeons against a northern Alberta doctor," says Carole Saindon of Health Canada.

"The College of Physicians and Surgeons recommends that complaints not be discussed publicly. Health Canada respects this recommendation."

Unsurprisingly, the College won't comment on Dr O'Connor's case, nor will the Alberta government.

The Athabasca oilsands (formerly called the tar sands) were long thought impractical to exploit. But high oil prices and technological innovations have made the area feasible to develop — and all of a sudden the province's accessible oil reserves rival Saudi Arabia's. But the catch is that to get oil from the bitumen (natural tar) enormous amounts of toxic waste water are created. And this raises concerns that profits from this development come at the expense of aboriginal lives.

"We need to know if there are excessive toxins in these resins and we need to see if people are dying from rare cancer or some devastating immune disorders — that someone is collecting some samples on these people to see what is the concentration of toxins," explained Dr Sauvé to Fort McMurray Today.

There have been some studies looking at the arsenic levels found in the region's fauna — but findings were contradictory. A recent study by Suncor, an oil company, found that a proposed development would lead to arsenic levels in moose meat — a local staple — 453 times the acceptable limit. The province and Imperial Oil dismissed the study saying their own data said the levels were much lower. Imperial Oil spokesperson Kim Fox stated back in November that her company's study estimated arsenic levels were 15 times lower than the Suncor numbers. "The people who actually conduct these studies tend to be very, very conservative in their methodologies. Even with these conservative approaches, what we've found is that oilsands do not contribute to increase in arsenic in the area."

Locals are not convinced. "Those big shots running our government — they don't give a darn who dies, they're not concerned about us," said one Fort Chipewyan elder in a CBC radio interview. "I've fished since I was 13 in Lake Athabasca. I've seen fish in the last five or six years with great lumps on them, humpbacks, crooked tails, some of the pickerel rotting alive — I've never seen that before in all the years I commercial fished. What are they putting into the water?"

Such cynicism towards the provincial government is commonplace among First Nations communities living near the oilsands developments. On March 6, the Mikisew Cree in Fort Chipewyan pulled out of the Cumulative Environmental Management Association (CEMA), dismissing the watchdog institution as a crock. "CEMA is a parking lot where everything, all the major issues, are placed. Meanwhile approvals [for new oilsands projects] are given," Mikisew spokesperson Sherman Sheh told the CBC. Indeed, CEMA was initially given five years to release an assessment on how much oil development the province could sustain without permanently wrecking the environment. It's already been seven years and CEMA hasn't released its report, all the while oilsands development has been continuing apace. The Athabaska Cree have also given up on CEMA.

Apocrine HS

Infliximab Liver Transplant PCS IBD

Gut -- eLetters for Biancone et al., 55 (2) 228-233

Not a random post, but some serious research. Did a government agency deny funding for Remicade because of money or risk? One is unacceptable, one is understandable. Personal- becoming political. A letter that is completely and utterly devoid of answers. Bureaucratic and impersonal. I want to throw up - this person should not have to die for money's sake.

Electronic Letters to:

Inflammatory bowel disease:
L Biancone, A Orlando, A Kohn, E Colombo, R Sostegni, E Angelucci, F Rizzello, F Castiglione, L Benazzato, C Papi, G Meucci, G Riegler, C Petruzziello, F Mocciaro, A Geremia, E Calabrese, M Cottone, and F Pallone
Infliximab and newly diagnosed neoplasia in Crohn’s disease: a multicentre matched pair study
Gut 2006; 55: 228-233 [Abstract] [Full text] [PDF]

Electronic letters published:

Colon cancer after infliximab therapy for Crohn’s disease in a young liver transplant recipient
Laurent Peyrin-Biroulet, Aude Bressenot, Laurence Chone, Philippe Denjean, Patrick Boissel, Marc-Andre Bigard, and Jean-Pierre Bronowicki (21 December 2005)


Colon cancer after infliximab therapy for Crohn’s disease in a young liver transplant recipient 21 December 2005

Laurent Peyrin-Biroulet,
Department of Hepato-Gastroenterology, University Hospital of Nancy, and INSERM U 724,
Aude Bressenot, Laurence Chone, Philippe Denjean, Patrick Boissel, Marc-Andre Bigard, and Jean-Pierre Bronowicki
Send letter to journal:
Re: Colon cancer after infliximab therapy for Crohn’s disease in a young liver transplant recipient

Email Laurent Peyrin-Biroulet, et al.

Dear Editor,

In a recent issue of the Journal[1], Biancone et al. showed a comparable frequency of new diagnosis of neoplasia in inflammatory bowel disease (IBD) patients treated with infliximab and in patients who never received infliximab. These data seem to confirm reassuring message from clinical trials.[2,3] A peculiar situation may be IBD patients having had liver transplantation for primary sclerosing cholangitis and in whom an increased risk of colon cancer has been reported. We here report a case of rapidly progressing colon cancer in a liver transplant recipient suffering from Crohn’s disease treated with infliximab.

A 23-year-old man had a 12-year long history of Crohn’s disease characterized by ileitis, pancolitis and oral aphthous ulcers. He was treated with mesalasine (2 g/day) since 1991 and azathioprine (2.5 mg/kg/day) since 1994. In September 2003, he underwent orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC) complicated by several angiocholitis. Tacrolimus and steroids were introduced after transplantation to prevent organ rejection. In November 2004, he has a flare-up of colitis despite maintenance treatment with azathioprine, tacrolimus and steroids. Colonoscopy showed moderate inflammation of the whole colon and mild ileitis. The random biopsy pattern including biopsies of the caecum (total of 45 biopsies) did not reveal any evidence of dysplasia. Infliximab therapy was thus initiated. From December 2004 to July 2005, he received a total of six infliximab infusions at 5 mg/kg (weeks 0, 2, 6 and then every 8 weeks) and was in clinical remission after three infusions. In July 2005, two weeks after his last infliximab infusion, he presented with a small bowel obstruction.

Computed tomography showed a stenosis of the caecum related to a bulky tumor with multiple one centimeter regional lymph nodes. Colonoscopy confirmed mucosal healing and showed a tumor of the caecum (Fig. 1), with a poorly differentiated adenocarcinoma on biopsies. The endoscopist could not reach the terminal ileum. The patient underwent a coloproctectomy in August 2005. Macroscopic examination revealed an exophytic mass with extension through the bowel wall and the pericolonic fat and the tumor size was 5-cm. Histologic examination showed a poorly differentiated adenocarcinoma of the caecum with a mucinous component (10%) and 19 of the 126 regional lymph nodes removed during surgery were positive for metastatic disease. Microscopic examination also found venous and nerve invasion. As staging of the cancer was pT4N2M0, adjuvant chemotherapy with oxaliplatin, fluorouracil and leucovorin was started in September 2005.

Figure 1. Endoscopic view of the tumor: A colonoscopy performed in July 2005 showed an exophytic lesion of the caecum responsible for a colon stenosis. The ileo-caecal valve was not visible and the endoscopist could not reach the terminal ileum.

Almost 30 cases of colon cancer have been described in liver transplant recipients with ulcerative colitis, but no case has yet been reported to our knowledge in Crohn’s disease.[4-10] Similarly to former reports, colon cancer was diagnosed within 30 months of transplantation with a duration of colitis of more than 9 years. While the youngest patient in these case reports was 39 years old[10] (mean age:c46[6]) and some patients had a history of colorectal neoplasia[5], our patient was only 25 years old and had neither personal nor family history of colon neoplasia. Previous reports indicated that the risk of colorectal carcinoma in IBD patients is related to the extent and duration of disease and might be increased by the coexistence of PSC. In the present case, the combination of these factors might be necessary but not sufficient to explain the development of colon cancer, as a colonoscopy with random biopsies performed just before the first infliximab infusion was normal. Given the development in only seven months of a bulky cancer of the caecum with multiple regional lymph metastases, infliximab therapy might have promoted and/or accelerated colon carcinogenesis in this young patient. This case advocates for a cautious use of infliximab in IBD patients with liver transplant.

We are grateful to Mathias Chamaillard for helpful discussions, and to Professor Colombel for critical reading of this manuscript.


1. Biancone L, Orlando A, Kohn A, et al. Infliximab does not increase the risk of newly diagnosed neoplasia in Crohn’s disease: a multicenter matched-pair study. Gut doi:10.1136/gut.2005.075937

2. Present DH, Rutgeerts P, Targan S, et al.. Infliximab for the treatment of fistulas in patients with Crohn's disease. N Engl J Med 1999;340:1398- 1405.

3. Sands BE, Anderson FH, Bernstein CN, et al. Infliximab maintenance therapy for fistulizing Crohn's disease. N Engl J Med 2004;350:876-885.

4. Higashi H, Yanaga K, Marsh JW, et al. Development of colon cancer after liver transplantation for primary sclerosing cholangitis associated with ulcerative colitis. Hepatology 1990;11:477-480.

5. Narumi S, Roberts JP, Emond JC, et al. Liver transplantation for sclerosing cholangitis. Hepatology 1995;22:451-457.

6. Fabia R, Levy MF, Testa G, et al. Colon carcinoma in patients undergoing liver transplantation. Am J Surg 1998;176:265-269.

7. Loftus EV Jr, Aguilar HI, Sandborn WJ, et al. Risk of colorectal neoplasia in patients with primary sclerosing cholangitis and ulcerative colitis following orthotopic liver transplantation. Hepatology 1998;27:685 -690.

8. Vera A, Gunson BK, Ussatoff V, et al. Colorectal cancer in patients with inflammatory bowel disease after liver transplantation for primary sclerosing cholangitis. Transplantation 2003;75:1983-1988.

9. Knechtle SJ, D'Alessandro AM, Harms BA, et al. Relationships between sclerosing cholangitis, inflammatory bowel disease, and cancer in patients undergoing liver transplantation. Surgery 1995;118:615-619.

10. Bleday R, Lee E, Jessurun J, et al. Increased risk of early colorectal neoplasms after hepatic transplant in patients with inflammatory bowel disease. Dis Colon Rectum 1993;36:908-912

Tuesday, April 03, 2007

Smoking and BBPV

Pharmacological Treatment of Vertigo Neurology Report - Find Articles

Pharmacological Treatment of Vertigo Neurology Report - Find Articles

Hanging out with people with motor deficits and watching Awakenings in the middle of the night and reading an article in a magazine about a "wobbler' got me thinking about whether dopamine might be implicated in balance. There seems to be something to my wild thought- I typed in vestibular+dopamine into google and will search a bit more eventually.

Monday, April 02, 2007

CFS Information

Screw The Cameras


If insurance industry consultants, patients, physicians, attorneys and judges can agree that there is a problem that needs fixing, it should be fairly easy to design better tools. For example, one could make FCE testing more realistic by extending its duration from two hours to four, and by bringing the patient back to repeat the testing over several consecutive days. There’s a downside risk, of course: Some patients will become much worse, perhaps irreversibly. However, that risk could be limited by close medical monitoring, both during and after each test. Insurance company staff should accompany the patient home and/or check in with them by phone at intervals. To ensure the accuracy of their reports, patients might agree to keep a camera in their home or a radio location surveillance device on their person for several days.

For what OTHER disease would one be expected to be surveilled to be believed?

Maybe they ought to figure out a way to do blood tests for genetic markers and all that neat SCIENCE_Y kinda stuff real doctors are supposed to do, rather than relying on Orwellian/Kafka-esque techniques.... Jump through hoops on camera you unlucky person you...

I know that they are trying to help- but please- insurance companies already surveil people to their DISADVANTAGE, so why should we trust them now?

This is a VERY BAD IDEA.

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